Andy Slavitt hints at MACRA delay

CMS Acting Administrator Andy Slavitt indicated at a Senate Finance Committee hearing Wednesday the agency may delay the start date of the Medicare Access and CHIP Reauthorization Act, or MACRA.

MACRA replaces the sustainable growth rate formula for physician payment adjustments under Medicare. Under the proposed rule, CMS would begin measuring performance in 2017 for payments that begin in 2019. This timeline has been of concern for physician practices that are still awaiting a final rule.

In response to these concerns, Mr. Slavitt said, "Every physician in the country needs to feel like they are set up for success," and to do that the agency "remain[s] open to alternative approaches," which include later start dates, shorter reporting periods and additional methods to ease physicians into the program.  

The American Hospital Association said it supports a number of the law's provisions, but requested a handful of changes in comments submitted to the Senate Finance Committee for Wednesday's hearing. These changes — which include expanding eligibility for the advanced Alternative Payment Model, allowing hospital-based physicians in the Merit-based Incentive Payment System to report CMS hospital quality program measures, and aligning the hospital meaningful use program with the corresponding category under MACRA — would allow hospitals and physicians to work together on the new payment models, AHA said.

Medical groups and physician associations are already lauding Mr. Slavitt's comments, as they assuage concerns about the proposed rule's fast-approaching implementation timeline.

"We are pleased that acting Administrator Slavitt, Secretary Burwell and their colleagues in the Obama Administration are working to give physicians a fair shot at success under MACRA," said American Medical Association President Andrew Gurman, MD.

"AMGA appreciates the thoughtful approach CMS is considering in implementing the payment reforms under MACRA," Donald Fisher, PhD, president and CEO of AMGA, a medical trade association, said in an emailed statement. "Even among the most advanced medical groups and integrated delivery systems, finalizing new regulations in November and beginning a measurement period January is not adequate time for retooling systems."

No official start date for MACRA has been confirmed. The final rule is expected this fall.


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